Have you seen these USMLE questions??? What exam are they from???

Discussion in 'Step I' started by ifitsthelastthingido, 10.29.14.

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  1. ifitsthelastthingido

    ifitsthelastthingido

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    I recently came across these questions on a practice exam at my school.

    Q) A 60 y/o man with 10 years history of alcoholism is admitted to hospital for treatment of acute esophageal bleeding. He is schedule for an operation. In order to relieve portal venous pressure to esophageal veins, it is most beneficial to join the portal vein to which of the following veins?

    a) Gastrodeudenal

    b) Inferior Vena Cava

    c) left gastroepiploic

    d) splenic

    e) superior mesenteric

    Ans: D
    **Found the EXCAT same question on a form website that says it's from NBME 7 Block 2

    Q2-A 52 y/o caucasian male is brought to the ER after repeated coffee-ground vomiting.After initial stabilization, endoscopy is performed revealing a deep, bleeding ulcer on the POSTERIOR WALL of the DUODENAL BULB.This ulcer has most likely penetrated which of the following arteries? Ans: Gastroduodenal

    Q: A 37-year-old woman has a renal cell carcinoma confined within the fascia of the right kidney. During nephrectomy using a posterolateral approach, which of the following layers is normally incised?

    A) Costal pleura

    B) Diaphragmatic pleura

    C) Parietal peritoneum

    D) Transversalis fascia

    E) Visceral peritoneum
    Ans: D


    My question is: where can I find the other two questions? I would like to have the resource they are taking practice questions from to start prepping for exams early! Also is NBME 7 a free practice test or one you have to pay for?

    Thanks!!!!!
     
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  3. Ismet

    Ismet PGY-fun SDN Administrator 5+ Year Member

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    You have to pay for NBME self-assessments, and they are Step 1 practice tests, not for your individual classes. Do not take an NBME exam now, it would be over your head at this point and not beneficial.

    Sounds like anatomy? BRS Anatomy was pretty good for practice questions if your exam is going to be board-style questions.
     
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  4. theprince911

    theprince911 2+ Year Member

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    The first one doesn't sound right.. why would you anastomose the portal vein to the splenic vein (which joins the superior mesenteric to MAKE the portal vein)?
    It sounds like they're asking about a portacaval anastomosis, which is a surgery that you do in severe cirrhosis to anastomose the portal vein to the inferior vena cave.. so I'd go with B
     
    Last edited: 10.29.14
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  5. SouthernSurgeon

    SouthernSurgeon Lifetime Donor 7+ Year Member

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    While I hate contributing to homework threads...

    Yes this is correct. The question is asking about surgical treatment of portal hypertension. The treatment, generally, is a portosystemic shunt. So to answer this question you need to think about options where vein A is in the portal system and vein B in the systemic system.

    Exactly as you've rationalized, anastomosing the splenic vein to the portal vein makes no sense since they are right in line with each other.

    Surgical options for a portosystemic shunt include spleno-renal, portocaval, and then other more creative options depending on what is available (I did an IMV-->left renal the last time I was on transplant)

    Also important to know is that the surgical options are really not used in emergent settings these days as they have largely been eclipsed by TIPS procedures done by radiology (transjugular intra hepatic portosystemic shunt)
     
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  6. ifitsthelastthingido

    ifitsthelastthingido

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    Thank you for the responses but I'm not concerned about the answers but WHERE these anatomy questions are coming from. The school I go to is obviously not making them themselves because I was able to do a simple google search and find them on USMLE board forms where people were discussing them!

    I'll move the question to USMLE section.

    Thanks.
     
  7. ifitsthelastthingido

    ifitsthelastthingido

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    I recently came across these questions on a practice exam at my medical school. With a simple Google search I was able to find that they are from USMLE practice tests like NBME 7. But I am not able to locate the second and third question. Has anyone done NBME 7 and confirm if they are also from this exam or are they from another exam? (and if possible what block???)

    ***Just to clarify I don't need the answers. I NEED THE RESOURCE! Thank you!


    Q) A 60 y/o man with 10 years history of alcoholism is admitted to hospital for treatment of acute esophageal bleeding. He is schedule for an operation. In order to relieve portal venous pressure to esophageal veins, it is most beneficial to join the portal vein to which of the following veins?

    a) Gastrodeudenal

    b) Inferior Vena Cava

    c) left gastroepiploic

    d) splenic

    e) superior mesenteric

    Ans: D
    **Found the EXCAT same question on a form website that says it's from NBME 7 Block 2

    Where is this Question from????
    Q2-A 52 y/o caucasian male is brought to the ER after repeated coffee-ground vomiting.After initial stabilization, endoscopy is performed revealing a deep, bleeding ulcer on the POSTERIOR WALL of the DUODENAL BULB.Thisulcer has most likely penetrated which of the following arteries? Ans: Gastroduodenal

    Where is this Question from?????
    Q: A 37-year-old woman has a renal cell carcinoma confined within the fascia of the right kidney. During nephrectomy using a posterolateral approach, which of the following layers is normally incised?

    A) Costal pleura

    B) Diaphragmatic pleura

    C) Parietal peritoneum

    D) Transversalis fascia

    E) Visceral peritoneum
    Ans: D


    My question is: where can I find the other two questions? I would like to have the resource they are taking practice questions from to start prepping for my anatomy final early! Again DONT need the answers or to discuss them!!!!

    Thanks!!!!!
     
  8. Ismet

    Ismet PGY-fun SDN Administrator 5+ Year Member

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    There is no need to create a new thread, please do not cross-post.

    The questions are probably coming from NBME exams or any number of board review material-UWorld, USMLERx, BRS, PreTest, etc. Why not ask the course director?
     
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  9. DermViser

    DermViser 5+ Year Member

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    You've already been given an answer to this simple question by @Ismet. The come from the NBME self-assessments which you pay for on the website. Since there are no answers, people discuss them on message boards to figure out what the right answers are.
     
  10. seminoma

    seminoma 2+ Year Member

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    Google tells you where the others are from, but I'm sure this is bordering on some kind of professionalism issue (your intention of finding the resource your professors pull exam questions from).
     
  11. ifitsthelastthingido

    ifitsthelastthingido

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    Google does not tell me where the second and third question is from.

    My intentions are true and pure. These were NOT from an exam BUT from a PRACTICE exam my school posted a week before our midterm. They supply a lot of resources for us but all the questions are straight forward first order types. I would like to prepare more intensely before the next exam with second and third order questions like such.

    Dear seminoma,
    If you can not be apart of the solution, you are apart of the problem. My professionalism has NEVER been questioned my whole life. There is no room for judgmental people here on this forum.

    So I want to study similar style questions so I know the material at my upmost ability. If you have an issue with that, than you will be in a world of hurt when you enter the real world after medical school and see how it really functions.
     

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